Acute Appendicitis, Correlating Histopathological Findings with clinical - is histopathology needed for all?’

Abstract

Background: Acute appendicitis is a most common presentation in general surgery department and thus appendectomy holds large number of emergency operations in the UK and most part of the world. Histopathological examination of the appendectomy specimens are routinely carried out. Aim: To correlate the histological findings of appendectomy specimens with the clinical diagnosis of acute appendicitis and need for routine histopathology. Methods: This is a retrospective analysis of 148 appendectomies carried out in a two tertiary care hospitals of Pakistan betweenJanuary and December 2014. The Histopathology reports of appendectomy specimens were retrieved. Data was analysed using SPSS 20.0. Results: 148 appendectomies were performed during the study period. The mean age of the patients was 31.6±11.2 years. Patients age >16 years were 82.4% and total number of female patients were 56.08%. Of the 148 resected appendix, 126(85.13%) had histopathology findings consistent with acute appendicitis. Around3.37% of the 148 specimens were abnormal pathologies other thaninflammation of the appendix. The negative appendectomy rate was 9.46%. Thefemale sex accounted for 64.28% of the negative appendectomies. Conclusion: Appendectomy in female gender results in high negative rate which can be overcome by judicious use of imaging studies. Unusual pathologies are rare and it can have impact on patient’s outcome, but it can be surgeon’s choice as per-operative findings are usually sufficient for identifying unexpected nature of condition. Through this it can not only have reduced financial burden on patients but also reduce workload of pathologists.